Neuro

Question 1

Crescendo TIA def

Answer 1

Two or more TIAs in a week

Question 2

Recognition of stroke in ED tool

Answer 2

ROSIER

Question 3

Initial management of TIA

Answer 3

Aspirin 300mg daily

Referred to specialist to be seen within 24hrs

Question 4

Secondary prevention of stroke

Answer 4

Clopidogrel
Atorvastatin
Carotid endarterectomy (when appropriate)

Question 5

Who gets MS and when does it present

Answer 5

Women under 50 classically

Symptoms improve in pregnancy and postpartum

Question 6

CNS or PNS affected in MS

Answer 6

CNS

Question 7

Classic presentation of symptoms in MS

Answer 7

Last for weeks then improve

Question 8

Common MS signs/ symptoms

Answer 8

Optic neuritis (LR6 lesion)
Focal weakness
Focal sensory symptoms
Ataxia

Question 9

What is Lhermitte’s sign

Answer 9

Electric shock sensation that travels down spine when stretching DCML

Question 10

Disease patterns in MS

Answer 10

Clinically isolated syndrome - first episode of demyelination

Relapsing remitting - episodes of disease followed by recovery

Secondary progressive - worsening now with incomplete remissions

Question 11

How to diagnose MS

Answer 11

MRI scan

Lumbar puncture shot oligoclonal bands

Question 12

How does optic neuritis present

Answer 12

Unilateral reduced vision developing over hours to days. Pain on movement. RAPD. Impaired colour vision. Central scotoma (enlarged blind spot)

Question 13

MS drug to treat relapses

Answer 13

500mg methylpred 5 days

Question 14

How does MND affect sensory neurones

Answer 14

It does not

Question 15

Most common type of MND

Answer 15

ALS

Amyotrophic lateral sclerosis

Question 16

Typical person to get MND

Answer 16

60M

Question 17

Typical MND presentation

Answer 17

60M with progressive weakness of muscles. Often worse in upper limbs. Clumsiness.

Question 18

Triad of Parkinsons

Answer 18

Resting tremor, rigidity and bradykinesia

Question 19

Does MND affect UMN or LMN

Answer 19

Both

Question 20

Does a PD tremor improve with rest

Answer 20

No

Worse at rest

Question 21

Does a PD tremor improve with ETOH

Answer 21

No

Question 22

Is a PD tremor symmetrical

Answer 22

No

Question 23

Main PD treatment

Answer 23

Levodopa

Question 24

What is entacapone

Answer 24

A PD drug - COMT inhibitor.

Question 25

Epilepsy definition

Answer 25

Tendency to have seizures

Question 26

First and second line treatments for tonic clonic seizure

Answer 26

1: sodium valproate 2: lamotrigine or carbamazepine

Question 27

Where do focal seizures start

Answer 27

Temporal lobe

Question 28

What do focal seizures affect

Answer 28

Hearing, speech, memory and emotions May present as hallucinations, flashbacks, deja vu, strange things on autopilot

Question 29

First line management of local seizures

Answer 29

Carbamazepine or lamotrigine

Question 30

First line treatment for absence seizures (2)

Answer 30

Sodium valproate | Ethosuximide